Distribution, Severity and Mortality of COVID-19 in Relation to Blood Group and Rh Factor

Gazmend Amzai; Milena  Srbinoska-Bogatinoska; Oliver  Karanfilski; Glorija  Stefanoska-Tosheska; Tatjana  Kjosevska; Eleonora  Grozdanova; Argjent  Muca; Tatjana  Proseva; Lidija  Poposka; Marija  Dimzova

doi:10.3889/oamjms.2026.12134

Authors

Gazmend Amzai
Milena Srbinoska-Bogatinoska Health Center Makedonski Brod, Republic of North Macedonia https://orcid.org/0009-0002-8248-4880
Oliver Karanfilski University Clinic for Hematology, Medical Faculty, Ss Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia https://orcid.org/0000-0002-2807-4242
Glorija Stefanoska-Tosheska General Hospital, Prilep, Republic of North Macedonia
Tatjana Kjosevska Health Center Shtip, Republic of North Macedonia
Eleonora Grozdanova General Hospital, Kochani, Republic of North Macedonia
Argjent Muca University Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Medical Faculty, Ss Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
Tatjana Proseva University Clinic for Endocrinology, Diabetes and Diseases of Metabolism, Medical Faculty, Ss Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia
Lidija Poposka University Clinic for Cardiology, Medical Faculty, Ss Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia https://orcid.org/0000-0002-2539-6828
Marija Dimzova University Clinic for Infectious Diseases and Febrile Conditions, Medical Faculty, Ss Cyril and Methodius University in Skopje, Skopje, Republic of North Macedonia https://orcid.org/0000-0002-1799-8079

DOI:

https://doi.org/10.3889/oamjms.2026.12134

Keywords:

COVID-19, ABO blood group system, Rh

Abstract

BACKGROUND: During the Covid-19 pandemic, a number of investigators reported that in patients with different blood groups the virus had a disparate influence regarding the severity and the outcome of the infection.

AIM: The goal of our study was to determine if there is an association between blood groups and Rh factor regarding the severity and mortality from COVID-19 in our analyzed patient population.

METHODS: We conducted a retrospective observational study of 250 patients with COVID-19 disease, treated as ambulatory or hospitalized patients in several health facilities during a time period of one year, from November 2020 till November 2021.

RESULTS: The majority of patients in our cohort were confirmed to have blood group A - 115 (46%), followed by blood group O - 67 (26.8%) patients, 45 (18%) patients were with blood group B, and 23 (9.2%) patients were with blood group AB. The data generated from our analysis revealed a higher than standard prevalence of SARS-CoV-2 infections among individuals with blood group A. Also, the analysis shows that patients with blood group A experience a more severe clinical course of the disease, as well as higher mortality, compared to patients with other blood groups. There is a substantial difference between Rh positive and Rh negative patients in terms of the severity of the disease. Rh positive patients more frequently experience a severe clinical course, confirmed by statistical significance, but the Rh factor does not affect the outcome of the infection.

CONCLUSIONS: The results from our analysis showed that patients with blood group A manifest a more severe clinical course of the disease and a higher mortality rate compared to patients with other blood groups, but statistical significance between them could not be documented.

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